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Shin splints

This is an excerpt from Athletic Taping, Bracing, and Casting 5th Edition With HKPropel Access by David H Perrin,Ian A McLeod.

The colloquial term shin splints refers to leg pain that arises from a variety of sources, such as arch strains, tendinitis, compartment syndrome, or stress fractures of the tibia or fibula. Seek the assistance of an experienced clinician to identify the source and mechanism of injury.

Arch Strains

A strain, or falling of the longitudinal arch, causes the tarsal bones of the foot to spread. The flattened foot can place undue stress where the extensor retinacula tie the anterior tendons to the leg, and the extra stress causes the patient to experience pain in the distal leg.

Tendinitis

Tendinitis may occur in any of the tendons that cross the ankle, but the posterior tibial tendon receives the greatest number of injuries. Running on uneven or banked surfaces that place one ankle in continuous eversion will precipitate injury. A hyperpronated foot could also contribute to the injury mechanism.

Compartment Syndrome

The tibia, fibula, and superficial fascia of the leg create a compartment through which the anterior muscles, the deep peroneal nerve, a vein, and an artery traverse. When the anterior muscles swell, they create chronic anterior compartment syndrome, producing leg pain and numbness that radiate into the foot.

Stress Fractures

Stress fractures to the tibia or fibula are a disruption to the periosteum and commonly occur in patients who engage in prolonged periods of running. No taping procedure will help the symptoms associated with a stress fracture. The patient usually requires 6 weeks of rest before the symptoms resolve.

Shin Splint Taping

A haphazard taping approach often prevails in the treatment of shin splints. Several techniques exist to remedy leg pain. If the pain occurs because of a fallen longitudinal arch, the patient may find relief from simple arch taping combined with two or three strips placed around the distal leg to support the extensor retinacula (see figure 2.30). A closed basketweave designed to limit eversion aids posterior tibial tendinitis. Patients have also reported relief from compression taping rather than from a procedure that supports the involved musculature (see figure 2.31). Kinesiology taping targeted at supporting the tibialis posterior, flexor digitorum longs, and flexor hallucis longus has also been reported to reduce pain complaints in patients with shin splints (see figure 2.32). No type of taping is likely to alleviate the effects of compartment syndrome or stress fractures.

Figure 2.30 Taping procedure for shin splints caused by a weakened or fallen longitudinal arch. The procedure combines simple arch taping with reinforcement of the ankle retinacula. The retinacula secure the anterior tendons of the leg.
Figure 2.30 Taping procedure for shin splints caused by a weakened or fallen longitudinal arch. The procedure combines simple arch taping with reinforcement of the ankle retinacula. The retinacula secure the anterior tendons of the leg.

Figure 2.31 Apply tape to the anterior leg to support shin splints. Begin the procedure with (a) proximal and distal and (b) medial and lateral anchor strips. Apply tape in an oblique direction pulling (c) medial to lateral and (d) lateral to medial (e) in an overlapping fashion. Completely cover the anterior aspect of the leg. (f) Apply medial and lateral anchor strips to (g) complete the procedure.
Figure 2.31 Apply tape to the anterior leg to support shin splints. Begin the procedure with (a) proximal and distal and (b) medial and lateral anchor strips. Apply tape in an oblique direction pulling (c) medial to lateral and (d) lateral to medial (e) in an overlapping fashion. Completely cover the anterior aspect of the leg. (f) Apply medial and lateral anchor strips to (g) complete the procedure.

Video 2.11 demonstrates the application of tape to the anterior leg to support shin splints.

Figure 2.32 Kinesiology taping for shin splints. (a) Begin with the patient in a supine position with the ankle in dorsiflexion and eversion. (b) Anchor the tape at the navicular bone, just below the medial malleolus. Apply the tape with little to no stretch around the medial malleolus and along the medial border of the tibia such that the area of pain is covered. Rub the tape to activate the adhesive. (c) Cut a Y slit in the next piece of tape. Anchor the tape posterior to the area of greatest pain complaint along the medial border of the tibia. Stretch each tail of the tape to full tension as you apply it in a transverse fashion over the area of greatest pain complaint and anchor the ends vertically along the anterolateral aspect of the leg. Rub the tape to activate the adhesive.
Figure 2.32 Kinesiology taping for shin splints. (a) Begin with the patient in a supine position with the ankle in dorsiflexion and eversion. (b) Anchor the tape at the navicular bone, just below the medial malleolus. Apply the tape with little to no stretch around the medial malleolus and along the medial border of the tibia such that the area of pain is covered. Rub the tape to activate the adhesive. (c) Cut a Y slit in the next piece of tape. Anchor the tape posterior to the area of greatest pain complaint along the medial border of the tibia. Stretch each tail of the tape to full tension as you apply it in a transverse fashion over the area of greatest pain complaint and anchor the ends vertically along the anterolateral aspect of the leg. Rub the tape to activate the adhesive.

Video 2.12 demonstrates the application of kinesiology tape to support shin splints.

More Excerpts From Athletic Taping, Bracing, and Casting 5th Edition With HKPropel Access

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